Used like a cigarette, produces a flavour aerosol mist with or without nicotine

On March 27th 2009, Health Canada issued an advisory against electronic cigarettes: “…may be marketed as safer alternative to conventional tobacco products and, in some cases, as an aid to quitting smoking, electronic smoking products may pose risks such as nicotine poisoning and addiction.”

Health Effects

Smokeless Tobacco contains 28 cancer causing agents (carcinogens).

Smokeless Tobacco contains a higher level of nicotine making them more addictive.

Smokeless Tobacco is associated with gum disease and tooth decay.

Smokeless Tobacco users increase their risk for cancer of the oral cavity.

Smokeless Tobacco may increase the risk of cardiovascular disease and strokes.

Smokeless Tobacco used during pregnancy increases the risk of preeclampsia, premature birth and low birth weight.

Smokeless Tobacco used by men causes reduced sperm count and abnormal sperm cells.

Not ready to quit? Visit your dentist annually and learn about self-oral exams to recognize changes or abnormal conditions of your mouth

Discuss with your Health Promotion facilitator about non-drug strategies for coping with cravings.

Staying Tobacco-free:

Support from family and friends.

Use your resources: Health Promotion, helpline, a quit buddy.

Keep active.

World Health Organization. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines. International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 89. Lyon (France): World Health Organization, 2007 [accessed 2011 Jan 26].

How to help a tobacco user to quit

A tough decision

Deciding to quit smoking is tough. Smokers make this decision in their own time, for their own reasons. You can’t do it for them, but you can help them to make the quitting process a little easier.

Quitting smoking is not just about stopping. It also means fighting physical and psychological addictions and changing strong habits.

Getting free of tobacco and giving up the pleasure of lighting up is a huge challenge. Many people are very addicted to nicotine. Quitting smoking can bring on physical and psychological symptoms like nervousness, irritability, difficulty concentrating, headaches, food cravings, insomnia, etc.

Things to avoid

You cannot force anyone to quit smoking. Keep in mind your goal is to help and avoid things that really don’t work.

Avoid preaching about the health hazard. Smokers already know it.

Avoid nagging. Be respectful, understanding and considerate.

Don’t suggest quitting is easy, or make fun of smokers.

Do not make smokers feel guilty about smoking and don’t blame them for doing it.

Are you willing to help?

Helping a smoker to quit is not easy. If you are willing to help your spouse, partner or a friend, here are some recommendations that can be useful.

Show them you are interested in the process and how optimistic you are, but don’t exaggerate.

Ask what you can do to be the most help. Do your best to respond to their needs, not what you think is best. Be available, but not pushy.

Be sympathetic about any physical discomfort caused by withdrawal from tobacco.

To avoid temptation, they may want to change some activities, stop seeing certain friends or going certain places for a while. Don’t complain! Just accept doing other activities and be available if your company is requested.

Expect different behaviour, especially during the first weeks. The ex-smoker may be cranky, nervous and even aggressive. Be understanding!

Be sensitive to their moods and needs. At different times, they may want help, or to be left alone. They may or may not want to talk. Make sure you’re not causing more stress when trying to help.

You can help even if you’re a smoker yourself

Even if you’re not ready to quit, you can help your friend or spouse to quit. You may feel you’re going to lose a smoking companion, but keep their interest in mind, not yours.

Don’t make fun of their preparation or attempts at quitting. Give your support, even if it causes you some inconvenience.

Help out by not smoking at certain times and places.

Don’t do things to encourage them to start smoking again (like offering a cigarette). Let them make their own choice about smoking.

If they relapse

Sometimes it takes several tries before a smoker succeeds in quitting. If your friend or spouse starts smoking again, don’t nag or complain. Let them know you understand that quitting is a very hard thing to do and that almost everyone slips sometimes.

All About Quitting Tobacco

Motivation

You’re on your way to quit using tobacco. You want to succeed and wonder what the best way is for you to quit. Quitting is a big decision. Your success depends on your motivation as well as having personalized strategies for dealing with difficult situations.

Most tobacco users quit on their own. Others join support groups or try different methods. But no matter what method you use, quitting depends entirely on you. No method is effective unless you’re truly committed to quit.

The best way to quit

To find the best way for you to quit, talk with your physician or pharmacist. The most effective approach is follow-up with your physician for the first month. Every tobacco cessation medication should be supported by a tobacco cessation program.

There are different medication options to assist in tobacco cessation that your physician or pharmacist will review with you. These include:

Non-nicotine medication such as buproprion (Zyban) and varenicline tartrate (Champix)

Nicotine replacement therapy such as the patch, gum, and inhalers.

Please consult your physician or pharmacist for more information.

Counselling is another option. Support groups like the “Butt Out” program offered by your Strengthening the Forces Health Promotion team can help you to quit. Participants offer mutual support to each other and the program can help you to understand and control your dependence on tobacco.

Be ready to quit

It’s tough to quit using tobacco because you must fight physical and psychological addictions, and change habits.

When you quit, you may experience symptoms due to the lack of nicotine in your system. The following symptoms may be experienced:

Craving to use tobacco

Irritability and impatience

Unusually strong emotional reactions

Insomnia

Difficulty concentrating

Dizziness and sweating

Faster heart beat

Hand tremors

Headaches

These reactions, which indicate that your body is getting back to normal, begin a few hours after you stop using tobacco. Many people experience their worst withdrawal symptoms the first day after stopping tobacco use. Symptoms begin to lessen after 3-4 days. After 10 days, most symptoms should be gone.

Tips to help cope with symptoms of withdrawal

Get help from your family and friends! Encourage your spouse/partner, a colleague, or a friend to quit at the same time as you. If that is not possible, ask them to give you their support and ask them not to use tobacco in your presence, at least for a short period of time. Without tobacco, you’ll sometimes feel alone in stressful situations. Open communication and the support of friends will help. Let people know what you are going through. Ask them for their support and understanding.

Cleanse your system. During the first weeks, drink plenty of water. This will help your body eliminate nicotine more quickly.

Change your routine. A change of habits will help you avoid the old reflexes of a tobacco user. For a few weeks, it would be best to avoid places, activities, or even people you associate with tobacco use. If necessary, drink less alcohol, cola, and coffee. After meals leave the table as quickly as possible, brush your teeth, then go outside, or keep busy. To keep your hands busy, scribble on a piece of paper, play with a rubber band, paper clip, or drink water.

Handling stress. No one is immune to stress. You must find other means than using tobacco to cope with stress. Most ex-users agree that physical activity is a useful mechanism to cope with stress and the urge to use tobacco. Replace your tobacco use with physical activities like walking, running, doing odd jobs around the house, gardening, or sports. Learn to relax. There are a number of options to practice relaxation; listening to soft music or sounds from nature, deep breathing, and taking a long bath or shower. Books, CD’s, and brochures explain simple exercises that may help in controlling your stress effectively.

If weight is a concern. Your appetite may increase after you quit using tobacco, or you may tend to replace tobacco with food. Ensure that you remain physically active and pay attention to what you are eating. When you’re hungry, chew sugarless gum, have a piece of fruit, a high fiber snack or popcorn, or drink water.

Don't give up!

Over the next few weeks, you will feel the urge to use tobacco again. Keep in mind that cravings rarely last more than 3-4 minutes.

When you experience cravings try the 4 D’s:

Delay

Drink water

Deep breathe

Do something different

If you started using tobacco again, don’t feel discouraged. Many people make more than one attempt to quit before they succeed. Just try again!

E-Cigarettes…. What are they and why they are controversial?

What are e-cigarettes?

Electronic cigarettes—e-cigarettes—are a rapidly evolving market. E-cigarettes are devices that release doses of vaporized solutions. The e-cigarette is battery-operated and heats liquid turning it into a vapour. The vapor is then inhaled, or "vaped". The cartridge contains flavouring and can also contain nicotine if the user chooses. Many users report that the e-cigarette provides a similar sensation to inhaling tobacco smoke, even though there is no smoke but rather, vapor.

Why E-Cigarettes are Controversial

Health experts are divided on the subject of e-cigarettes. Some experts see e-cigarettes as a way to decrease the harm resulting from the many toxins contained within tobacco. Others fear the popularity of e-cigarettes undermines the many years of hard work around effective tobacco control. E-cigarettes have not undergone extensive clinical trials to prove their safety and their efficacy in helping smokers quit. In essence, while e-cigarettes don’t produce second-hand smoke or any smoke for that matter, ‘safer’ does not equate to ‘safe’. Others fear e-cigarettes may become a gateway to smoking for youth. Moreover, e-cigarettes could undermine smoking cessation efforts if they promote dual use among smokers. As renowned health expert André Picard noted “research on e-cigarettes – about their potential harms and potential benefits – is in its infancy. Data on long-term risks and benefits are especially lacking.”

The World Health Organization

The World Health Organization (WHO) wants to ban the sale of the devices to minors, increase restrictions on advertising along with barring their use indoors and in workplaces according to reports released in August, 2014. The report also recommends a ban on fruit and candy-flavoured e-cigarettes as they may attract children and youth. E-cigarettes are often marketed by manufacturers as aids to quit smoking, or as healthier alternatives to tobacco. The WHO report highlights concerns about the tobacco industry’s control of the $3 billion e-cigarette market. While they are likely less toxic than conventional cigarettes, the report illustrates how e-cigarette aerosol is not simply water vapor, as is often claimed in marketing material. The devices also increase the exposure of non-smokers and bystanders to nicotine and a number of toxins.

“E-cigarettes are a story of both risks and promises. In a sense they are a double-edged sword,” according to Dr. Douglas Bettcher, director of WHO's Department for Prevention of Non-communicable Diseases. He further noted that “The tobacco industry is taking greater share — as public health partners pretending to be part of the solution to the health disaster they have created.”

Health Canada’s Response

Health Canada’s latest guidelines on e-cigarettes were released in 2009. Currently, e-cigarettes that contain nicotine, or that claim they can help users quit smoking, are regulated under the federal Food and Drugs Act of Canada. E-cigarettes without nicotine or health-related claims can be imported, advertised and sold across Canada without restrictions. However it is worthy to note as a result of the lack of regulation federally and provincially, this led the municipality of Red Deer to ban the product totally. As well, Toronto’s medical officer of health recommended a city-wide ban on the products, but the city council voted instead to ban the products from city property.